Psychotropic Medication Prescribing to Patients with Dementia Admitted to Acute Hospitals in Ireland
ConclusionThis audit provides baseline data on psychotropic medication prescription for NCSD in Irish hospitals prior to a specific Irish guideline on this topic. Reflecting this, most PwD were receiving psychotropic medications on admission, and many were prescribed new/increased psychotropic medication in hospital, often without evidence of appropriate decision making and prescribing processes. (Source: Drugs and Aging)
Source: Drugs and Aging - March 30, 2023 Category: Geriatrics Source Type: research
Safety and Tolerability of Antimicrobial Agents in the Older Patient
AbstractOlder patients are at high risk of infections, which often present atypically and are associated with high morbidity and mortality. Antimicrobial treatment in older individuals with infectious diseases represents a clinical challenge, causing an increasing burden on worldwide healthcare systems; immunosenescence and the coexistence of multiple comorbidities determine complex polypharmacy regimens with an increase in drug –drug interactions and spread of multidrug-resistance infections. Aging-induced pharmacokinetic and pharmacodynamic changes can additionally increase the risk of inappropriate drug dosing, with u...
Source: Drugs and Aging - March 28, 2023 Category: Geriatrics Source Type: research
TANGO: Development of Consumer Information Leaflets to Support TAperiNG of Opioids in Older Adults with Low Back Pain and Hip and Knee Osteoarthritis
ConclusionsThis study led to the development of a leaflet and personal plan to support the reduction of opioid use in older people with LBP or HoKOA. The development of the consumer leaflets incorporated feedback provided by HCPs and consumers to maximise clinical effectiveness and future intervention implementation. (Source: Drugs and Aging)
Source: Drugs and Aging - March 27, 2023 Category: Geriatrics Source Type: research
The Relationship of Continuity of Care, Polypharmacy and Medication Appropriateness: A Systematic Review of Observational Studies
ConclusionsDifferences regarding the methodological quality of included studies as well as the heterogeneity in terms of the operationalization and measurement of COC, polypharmacy, and MARO need to be considered when interpreting the results. Yet, our findings suggest that optimizing COC may be helpful in reducing polypharmacy and MARO. Therefore, COC should be acknowledged as an important risk factor for polypharmacy and MARO, and the importance of COC should be considered when designing future interventions targeting these outcomes. (Source: Drugs and Aging)
Source: Drugs and Aging - March 27, 2023 Category: Geriatrics Source Type: research
From Drugs to Dry Mouth: A Systematic Review Exploring Oral and Psychological Health Conditions Associated with Dry Mouth in Older Adults with Polypharmacy
ConclusionsHigh levels of physical health conditions of dry mouth are observed in older adults and, to a lesser extent, psychological health conditions. These conditions can negatively affect quality of life. There remains a need to prevent dry mouth and the adverse health conditions associated with it in older adults. The modifiable nature of polypharmacy could be targeted to minimise, and potentially prevent, dry mouth. The optimisation of medication regimes to effectively treat chronic conditions, but also limit the likelihood of dry mouth, is a practical approach. Dry mouth prevention should be a priority and polypharm...
Source: Drugs and Aging - March 21, 2023 Category: Geriatrics Source Type: research
Current Management of Hypertension in Older Adults
AbstractHypertension is a major global health issue and it accounts for a big proportion of disability and mortality worldwide even in adults aged 65 years and above. Moreover, advanced age per se is an independent risk factor for adverse cardiovascular events and there is abundant scientific evidence supporting the beneficial effects of blood pressure lowering, within certain limits, in this subset of hypertensive patients. The aim of this review article is to summarize the available evidence regarding the appropriate management of hypertension in this specific subgroup, in an era of a constantly increasing aging populati...
Source: Drugs and Aging - March 18, 2023 Category: Geriatrics Source Type: research
Trends, Patterns and Associated User Characteristics of Antidepressant Prescriptions in Older Adults: A Nationwide Descriptive Cohort Study in Denmark
ConclusionSSRIs were the most commonly redeemed antidepressants, with consistent trends in Danish older adults. Besides clinical conditions, sociodemographics, e.g., sex, age, ethnicity, and place of residence, may influence antidepressant use. (Source: Drugs and Aging)
Source: Drugs and Aging - March 15, 2023 Category: Geriatrics Source Type: research
Treating Lower Urinary Tract Symptoms in Older Adults: Intravesical Options
This article provides an overview of the diagnosis and the treatment of lower urinary tract symptoms in older adults complicated by the neurodegenerative changes in the micturition reflex and further confounded by age-related decline in hepatic and renal clearance raising the propensity of adverse drug reactions. The first-line drug treatment for lower urinary tract symptoms, orally administered antimuscarinics, fails to reach the equilibrium dissociation constant of muscarinic receptors even at their maximum plasma concentration and tends to evoke a half-maximal response at a muscarinic receptor occupancy of just 0.206% i...
Source: Drugs and Aging - March 6, 2023 Category: Geriatrics Source Type: research
Optimising Medications in Older Vascular Surgery Patients Through Geriatric Co-management
ConclusionsGeriatric co-management was associated with an improvement in guideline-recommended antiplatelet agent prescribing aimed at cardiovascular risk modification for older vascular surgery patients. The prevalence of potentially inappropriate medications was high in this population, and was not reduced with geriatric co-management. (Source: Drugs and Aging)
Source: Drugs and Aging - March 2, 2023 Category: Geriatrics Source Type: research
Management of Older Adults with Sickle Cell Disease: Considerations for Current and Emerging Therapies
This article summarizes the available evidence for managing older adults with SCD and dis cusses potential challenges to using approved and emerging drugs in this population. (Source: Drugs and Aging)
Source: Drugs and Aging - February 28, 2023 Category: Geriatrics Source Type: research
A Motivational Interviewing Intervention to Improve Adherence to ACEIs/ARBs among Nonadherent Older Adults with Comorbid Hypertension and Diabetes
ConclusionPatients who received the MI intervention were more likely to be adherent at 6 and 12 months following the intervention initiation, despite gaps in the follow-up calls due to COVID-19. Pharmacist-led MI intervention is an effective behavioral strategy to improve medication adherence among older adults and tailoring the intervention to past adherence patterns may enhance the intervention effectiveness.This study was registered with the United States National Institutes of Health (ClinicalTrials.gov identifier NCT03985098). (Source: Drugs and Aging)
Source: Drugs and Aging - February 27, 2023 Category: Geriatrics Source Type: research
New Migraine Drugs for Older Adults
AbstractMigraine is one of the most widespread and burdensome diseases, affecting one in every seven individuals in the world, for an estimated global prevalence of 14%. Until recently, therapeutic choices for older migraineurs have been limited by safety concerns and such patients have typically been excluded from clinical trials. However, randomized controlled trials (RCTs) of new migraine drugs have begun to include participants aged over 65 years, offering clinicians relevant safety and efficacy data to be able to treat older patients with the newest drug classes, including monoclonal antibodies for CGRP (r), CGRP anta...
Source: Drugs and Aging - February 24, 2023 Category: Geriatrics Source Type: research
Inappropriate Combined Antiplatelet and Anticoagulant Therapy in Older Patients with Atrial Fibrillation: Trend over Time (2009 –18)
ConclusionsWhile inappropriate combined antiplatelet and anticoagulant therapy has declined over the last decade, there is still room for improvement. Antiplatelet deprescribing should be considered in all patients with inappropriate combined antiplatelet and anticoagulant therapy, including those with vascular disease and no recent cardiovascular event. (Source: Drugs and Aging)
Source: Drugs and Aging - February 23, 2023 Category: Geriatrics Source Type: research
Sodium-Glucose Cotransporter 2 Inhibitors in Frail Patients with Heart Failure: Clinical Experience of a Heart Failure Unit
ConclusionsWhen prescribing in heart failure, it is important to remember that frail patients are more likely to have adverse effects with the use of sodium glucose cotransporter 2 inhibitors, of which the most common are those related to osmotic diuresis. Nonetheless, these do not appear to increase the risk of discontinuation or abandonment of therapy in this population. (Source: Drugs and Aging)
Source: Drugs and Aging - February 21, 2023 Category: Geriatrics Source Type: research
Chronic Urticaria in Older Adults: Treatment Considerations
AbstractChronic urticaria is characterized by recurrent wheals and/or angioedema lasting for more than 6 weeks. Chronic urticaria is an extremely disabling disease limiting daily activities, compromising patient quality of life, and frequently associated with psychiatric comorbidities (depression and/or anxiety). Unfortunately, there are still gaps in the knowledge regarding treatment in special populations, especially in older patients. Indeed, there are no specific recommendations for the management and treatment of chronic urticaria in older people; therefore, recommendations for the general population are used. However...
Source: Drugs and Aging - February 18, 2023 Category: Geriatrics Source Type: research
